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1 Jul, 2023

BCBSRI notification of admission process

As a reminder, BCBSRI in-network and out-of-network behavioral health services only require a notification of admission.

Per this process, admitting facilities must notify BCBSRI behavioral health within 48 hours of a member’s admission to/discharge from any one of the following levels of care, to ensure correct claims processing:

  • Inpatient mental health
  • Inpatient withdrawal management (detoxification)/rehab
  • Crisis stabilization
  • Residential treatment center (mental health and/or substance use disorder)
  • Partial hospitalization (mental health and/or substance use disorder)
  • Intensive outpatient (mental health and/or substance use disorder)
  • Child and family intensive treatment (CFIT)
  • Applied behavior analysis (ABA)
  • Transcranial magnetic stimulation (TMS)

Of note, the Federal Employee Program (FEP) is exempt from the notification of admission process. A medical necessity review is still required for the following in-network behavioral health services:

  • Inpatient mental health
  • Inpatient withdrawal management
  • Residential treatment center (mental health and/or substance use disorder)
  • Applied behavior analysis (ABA)
  • Transcranial magnetic stimulation (TMS)